By Becky Booth, Wilma Fellman, LPC, Judy Greenbaum, Ph.D., Terry Matlen, ACSW, Geraldine Markel, Ph.D., Howard Morris, Arthur L. Robin, Ph.D., Angela Tzelepis, Ph.D.

The following myths – and factual responses – have been collected
from rebuttals to recent media articles about ADD/ADHD. The
rebuttals were written by MAAAN (Metro Area Adult ADHD
Network, based in the Detroit area).

Myth #1: ADHD is a “phantom disorder.” FACT: The
existence of a neurobiological disorder is not an issue to be
decided by the media through public debate, but rather as a matter
of scientific research. Scientific studies spanning 95 years
summarized in the professional writings of Dr. Russell Barkley,
Dr. Sam Goldstein, and others have consistently identified a group
of individuals who have trouble with concentration, impulse
control, and in some cases, hyperactivity. Although the name given
to this group of individuals, our understanding of them, and the
estimated prevalence of this group has changed a number of times
over the past six decades, the symptoms have consistently been
found to cluster together. Currently called Attention Deficit
Hyperactivity Disorder, this syndrome has been recognized as a
disability by the courts, the United States Department of
Education, the Office for Civil Rights, the United States Congress,
the National Institutes of Health, and all major professional
medical, psychiatric, psychological, and educational associations.

Myth #2: Ritalin is like cocaine, and the failure to give
youngsters drug holidays from Ritalin causes them to develop
psychosis. FACT: Methylphenidate (Ritalin) is a medically
prescribed stimulant medication that is chemically different from
cocaine. The therapeutic use of methylphenidate does NOT CAUSE addiction or dependence, and does not lead to psychosis.
Some children have such severe ADD symptoms that it can be
dangerous for them to have a medication holiday, for example a
child who is so hyper and impulsive he’ll run into traffic without
stopping to look first. Hallucinations are an extremely rare side effect of methylphenidate, and their occurrence has nothing to do
with the presence or absence of medication holidays. Individuals
with ADHD who are properly treated with stimulant medication
such as Ritalin have a lower risk of developing problems with
alcohol and other drugs than the general population. More
importantly, fifty years of research has repeatedly shown that
children, adolescents, and adults with ADHD safely benefit from
treatment with methylphenidate.

Myth #3: No study has ever demonstrated that taking
stimulant medications can cause any lasting behavioral or
educational benefit to ADHD children. FACT: Research has
repeatedly shown that children, adolescents, and adults with
ADHD benefit from therapeutic treatment with stimulant
medications, which has been used safely and studied for more than
50 years. For example, The New York Times reviewed a recent
study from Sweden showing positive long- term effects of
stimulant medication therapy on children with ADHD. Readers
interested in more studies on the effectiveness of medication with
ADHD should consult the professional writings of Dr. Russell
Barkley, Drs. Gabrielle Weiss and Lily Hechtman, and Dr. Joseph
Biederman.

Myth #4: ADHD kids are learning to make excuses, rather
than take responsibility for their actions. FACT: Therapists,
educators, and physicians routinely teach children that ADHD is a
challenge, not an excuse. Medication corrects their underlying
chemical imbalance, giving them a fair chance of facing the
challenges of growing up to become productive citizens.
Accommodations for the disabled, as mandated by federal and
state laws, are not ways of excusing them from meeting society’sresponsibilities, but rather make it possible for them to compete on
a leveled playing field.

Myth #5: ADHD is basically due to bad parenting and lack of
discipline, and all that ADHD children really need is old-fashioned discipline, not any of these phony therapies. FACT:
There are still some parent-bashers around who believe the
century-old anachronism that child misbehavior is always a moral
problem of the “bad child.” Under this model, the treatment has
been to “beat the Devil out of the child.” Fortunately, most of us
are more enlightened today. A body of family interaction research
conducted by Dr. Russell Barkley and others has unequivocally
demonstrated that simply providing more discipline without any
other interventions worsens rather than improves the behavior of
children with ADHD. One can’t make a paraplegic walk by
applying discipline. Similarly, one can’t make a child with a
biologically-based lack of self-control act better by simply
applying discipline alone.

Myth #6: Ritalin is unsafe, causing serious weight loss, mood
swings, Tourette’s syndrome, and sudden, unexplained
deaths. FACT: Research has repeatedly shown that children,
adolescents, and adults with ADHD benefit from treatment with
Ritalin (also known as methylphenidate), which has been safely
used for approximately 50 years. There are NO published cases of
deaths from overdoses of Ritalin; if you take too much Ritalin, you
will feel terrible and act strange for a few hours, but you will not
die. This cannot be said about many other medications. The
unexplained deaths cited in some articles are from a combination
of Ritalin and other drugs, not from Ritalin alone. Further
investigation of those cases has revealed that most of the children
had unusual medical problems which contributed to their deaths. It
is true that many children experience appetite loss, and some
moodiness or “rebound effect” when Ritalin wears off. A very
small number of children may show some temporary tics, but these
do not become permanent. Ritalin does not permanently alter growth, and usually does not result in weight loss. Ritalin does not
cause Tourette’s syndrome, rather many youngsters with Tourette’s
also have ADHD. In some cases, Ritalin even leads to an
improvement of the of tics in children who have ADHD and
Tourette’s.

Myth #7: Teachers around the country routinely push pills on
any students who are even a little inattentive or
overactive. FACT: Teachers are well-meaning individuals who
have the best interests of their students in mind. When they see
students who are struggling to pay attention and concentrate, it is
their responsibility to bring this to parents’ attention, so parents can
take appropriate action. The majority of teachers do not simply
push pills- they provide information so that parents can seek out
appropriate diagnostic help. We do agree with the position that
teachers should not diagnose ADHD. However, being on the front
lines with children, they collect information, raise the suspicion of
ADHD, and bring the information to the attention of parents, who
then need to have a full evaluation conducted outside the school.
The symptoms of ADHD must be present in school and at home
before a diagnosis is made; teachers do not have access to
sufficient information about the child’s functioning to make a
diagnosis of ADHD or for that matter to make any kind of medical
diagnosis.

Myth #8: Efforts by teachers to help children who have
attentional problems can make more of a difference than
medications such as Ritalin. FACT: It would be nice if this were
true, but recent scientific evidence from the multi-modal treatment
trials sponsored by the National Institute of Mental Health suggests
it is a myth. In these studies, stimulant medication alone was
compared to stimulant medication plus a multi-modal
psychological and educational treatment, as treatments for children
with ADHD. The scientists found that the multi-modal treatment
plus the medication was not much better than the medication alone.
Teachers and therapists need to continue to do everything they can to help individuals with ADHD, but we need to realize that if we
don’t also alter the biological factors that affect ADHD, we won’t
see much change.

Myth #9: CH.A.D.D. is supported by drug companies, and
along with many professionals, are simply in this field to make
a quick buck on ADHD. FACT: Thousands of parents and
professionals volunteer countless hours daily to over 600 chapters
of CH.A.D.D. around the U.S. and Canada on behalf of individuals
with ADHD. CH.A.D.D. is very open about disclosing any
contributions from drug companies. These contributions only
support the organization’s national conference, which consists of a
series of educational presentations, 95% of which are on topics
other than medications. None of the local chapters receive any of
this money. It is a disgrace to impugn the honesty and efforts of all
of these dedicated volunteers. CH.A.D.D. supports all known
effective treatments for ADHD, including medication, and takes
positions against unproven and costly remedies.

Myth #10: It is not possible to accurately diagnose ADD or
ADHD in children or adults. FACT: Although scientists have
not yet developed a single medical test for diagnosing ADHD,
clear-cut clinical diagnostic criteria have been developed,
researched, and refined over several decades. The current generally
accepted diagnostic criteria for ADHD are listed in the Diagnostic
and Statistical Manual of Mental Disorders (DSM-IV) published
by the American Psychiatric Association (1995). Using these
criteria and multiple methods to collect comprehensive information
from multiple informants, ADHD can be reliably diagnosed in
children and adults.

Myth #11: Children outgrow ADD or ADHD. FACT: ADHD is
not found just in children. We have learned from a number of
excellent follow-up studies conducted over the past few decades
that ADHD often lasts a lifetime. Over 70% of children diagnosed
as having ADHD will continue to manifest the full clinical
syndrome in adolescence, and 15-50% will continue to manifest the full clinical syndrome in adulthood. If untreated, individuals
with ADHD may develop a variety of secondary problems as they
move through life, including depression, anxiety, substance abuse,
academic failure, vocational problems, marital discord, and
emotional distress. If properly treated, most individuals with
ADHD live productive lives and cope reasonably well with their
symptoms.

Myth #12: Methylphenidate prescriptions in the U.S. have
increased 600%. FACT: The production quotas for
methylphenidate increased 6-fold; however that DEA production
quota is a gross estimate based on a number of factors, including
FDA estimates of need, drug inventories at hand, EXPORTS, and
industry sales expectations. One cannot conclude that a 6-fold
increase in production quotas translates to a 6-fold increase in the
use of methylphenidate among U.S. children any more than one
should conclude that Americans eat 6 times more bread because
U.S. wheat production increased 6-fold even though much of the
grain is stored for future use and export to countries that have no
wheat production. Further, of the approximately 3.5 million
children who meet the criteria for ADHD, only about 50% of them
are diagnosed and have stimulant medication included in their
treatment plan. The estimated number of children taking
methylphenidate for ADD suggested in some media stories fails to
note that methylphenidate is also prescribed for adults who have
ADHD, people with narcolepsy, and geriatric patients who receive
considerable benefit from it for certain conditions associated with
old age such as memory functioning. (see Pediatrics, December
1996, Vol. 98, No. 6)